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Adding a visual linear scale probability to the PIOPED probability of pulmonary embolism
F Christiansen1, T Nilsson, K Måre
1Department of Diagnostic Radiology, Orebro Medical Center Hospital, Sweden.
Acta Radiologica (Stockholm, Sweden : 1987)
|May 1, 1997
Summary
Adding a visual linear scale (VLS) to the PIOPED categorization for pulmonary embolism diagnosis did not improve accuracy. This study suggests VLS does not enhance lung scintigraphy reporting compared to the standard PIOPED method alone.
Area of Science:
- Radiology and Nuclear Medicine
- Diagnostic Imaging
Background:
- Pulmonary embolism diagnosis relies on lung scintigraphy, often reported using the PIOPED categorical probability scale.
- The PIOPED scale offers a wide interpretation range, prompting investigation into enhanced reporting methods.
Purpose of the Study:
- To evaluate if a visual linear scale (VLS) probability assessment improves lung scintigraphy reporting accuracy when added to the standard PIOPED categorical probability for pulmonary embolism.
Main Methods:
- Re-evaluation of lung scintigrams from 170 patients previously assessed with both scintigraphy and pulmonary angiography.
- Three raters assessed pulmonary embolism probability using both PIOPED categorization and a VLS, with re-testing after six months.
Main Results:
- No significant difference in the area under the ROC curve was found between PIOPED categorization and VLS for any rater.
- Inter-rater agreement and repeatability analysis showed low agreement in the mid-probability range.
Conclusions:
- A visual linear scale probability estimate did not significantly enhance diagnostic accuracy compared to the PIOPED categorical assessment alone.
- The study does not recommend adding a VLS to the PIOPED categorization for pulmonary embolism diagnosis based on current findings.